Via Verde Medical Group, Inc | |
1125 Via Verde San Dimas CA 91773-4400 | |
(909) 592-9778 | |
(909) 599-6126 |
Full Name | Via Verde Medical Group, Inc |
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Speciality | Family Medicine |
Location | 1125 Via Verde, San Dimas, California |
Authorized Official Name and Position | Steven E Davis (OWNER) |
Authorized Official Contact | 9095929778 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Via Verde Medical Group, Inc 1125 Via Verde San Dimas CA 91773-4400 Ph: (909) 592-9778 | Via Verde Medical Group, Inc 1125 Via Verde San Dimas CA 91773-4400 Ph: (909) 592-9778 |
NPI Number | 1639109713 |
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Provider Enumeration Date | 07/04/2006 |
Last Update Date | 02/19/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639109713 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20A5217 (California) | Primary |
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